Bloom Counseling & Consultation

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

BLOOM COUNSELING & CONSULTATION

Doing business as

Bloom Counseling and Consultation

Practice address

1824 Memorial Dr
Clarksville, TN 37043-4605

Phone

(253) 380-0038

NPI assigned

Dec 9, 2024

Last updated

Dec 9, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Corrie Lee Larson, LICSWNPI 1487910246

Title

Ceo/Owner

Phone

(253) 380-0038

Specialties & licenses 1

Addresses

Other names 1

• Bloom Counseling and Consultation Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Corrie Lee Larson, MSW

  • Clinical Social Worker
  • Fort Campbell, KY
  • NPI 1487910246
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1467268045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 HARROWGATE DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370431596",
            "telephone_number": "253-380-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 MEMORIAL DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434605",
            "telephone_number": "253-380-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM COUNSELING & CONSULTATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-08",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "CORRIE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "253-380-0038",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bloom Counseling and Consultation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Morgan Blick, PHARMD
• Elizabeth Ruth Blight, LMT
• Kelsey Leigh Blik
• Nicole Blocker
• Ranielle Lea Blohm, PSYD
• Bloom Therapy Center, LLC
• Shacarra Blount, M.ED
• Blue Sprig Pediatrics
• Nicholas Ukaih Blunk
• Lelia Suzanne Boadway, B.S

• Adult Mental Health Clinic/Center in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Adult Mental Health Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.